Although there is increasing evidence that
vitamins influence pancreatic
adenocarcinoma biology and
carcinogenesis, a comprehensive review is lacking. In this study, we performed a PubMed literature search to review the anticancer mechanisms and the preclinical and clinical studies that support the development of the bioactive
vitamins A, C, D, E, and K in
pancreatic cancer intervention. Preclinical studies have shown promising results for
vitamin A in
pancreatic cancer prevention, with clinical trials showing intriguing responses in combination with
immunotherapy. For
vitamin C, preclinical studies have shown slower
tumor growth rates and/or increased survival when used alone or in combination with
gemcitabine, with clinical trials with this combination revealing decreased primary
tumor sizes and improved performance status. Preclinical studies with
vitamin D analogues have shown potent antiproliferative effects and repression of migration and invasion of
pancreatic cancer cells, with a clinical trial showing increased time to progression when calciferol was added to
docetaxel. For
vitamin E, preclinical studies have shown that δ-
tocotrienol and γ-
tocotrienol inhibited
tumor cell growth and survival and augmented
gemcitabine activity. Early-phase clinical trials with δ-
tocotrienol are ongoing.
Vitamin K demonstrates activation of apoptosis and inhibition of cellular growth in pancreatic
tumor cells; however, there are no clinical studies available for further evaluation. Although preclinical and clinical studies are encouraging, randomized controlled trials with endpoints based on insights gained from mechanistic and preclinical studies and early-phase clinical trials are required to determine the efficacy of bioactive
vitamin interventions in
pancreatic cancer.